Differentiating Depressed From Anxious Neurotic Outpatients

Considerable overlap exists between anxiety states and depressive reactions among neurotic outpatients, and their differentiation has diagnostic theoretical and therapeutic implications. Discriminant analysis provided separation of 364 outpatients clinically diagnosed as depressed from an equal number diagnosed as anxious neurotic. The Symptom Checklist (SCL), a 58-item patient self-report inventory, was used for the discrimination. Patients diagnosed as depressed reported themselves as more severely impaired on most items and factors. When levels of depression were held constant, however, the anxious patients reported more somatization. About 35% of the patients could not be assigned correctly. Findings are interpreted as supporting the separation of anxious and depressed states within the larger group of neurotic affective disorders. A mixture of intensity and configurational trends may account for the difficulties experienced by previous investigators in distinguishing between these two clinical groups.